Gastric duplication cysts: literature review and a case report of rare multiple gastric duplication cysts treated by endoscopic submucosal dissection

ABSTRACT

Gastric duplication cysts (GDCs) are rare structural abnormalities, especially in adults. We first report a rare case of small multiple GDCs in a woman, which presents as a submucosal tumor (SMT) at the gastric antrum. In consideration of the patient’s request for surgical treatment and minimally invasive resection, endoscopic submucosal dissection (ESD) was performed to remove the cyst. The case provides a reference for ESD surgery to remove small GDCs. So far, there is no consensus or practice guidelines for the diagnosis and management of GDCs. Herein we perform a comprehensive literature review and discussion on GDCs. GDCs are ‘repetitive’ cystic or tubular structures of gastric mucosa and muscularis mucosae, and share the muscularis propria and serous layer with the normal gastric wall. GDCs protruding into the stomach cavity can be diagnosed by endoscopic ultrasound (EUS), which has higher specificity and accuracy than CT and MRI. Some GDCs may cause complications, even cancerization. Therefore, we suggest that once found, the GDCs could be completely resected. For GDCs protruding into the stomach cavity, endoscopic surgery such as ESD can be adopted to remove the lesion. Endoscopic full-thickness resection (EFTR) may become an option for larger GDCs in the future. For extraluminal GDC, laparoscopic surgery is currently preferred. In this review, we summarized the structural and histopathological characteristics of GDCs and various treatment therapies, in order to provide experience and reference for the diagnosis and treatment of GDCs in the future.

KEYWORDS:

• Gastric duplication cysts
• adult
• submucosal tumor
• endoscopic ultrasound
• endoscopic submucosal dissection

Declaration of financial/other relationships

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

Ziying Yuan, Hongyun Wei and Bin Cao collected clinical data of the patient, and did literature search; Ziying Yuan analyzed the data and drafted the manuscript; Yuejuan Zhang helped in collecting and interpretation of pathological data and revised the paper; Hao Yuan had the idea, provided the case and interpreted the data; Hao Yuan and Baoguo He helped in conception and design of the paper, and revised the paper. All authors have read and approved the final manuscript.

Ethics statement

The work has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The patient gave her informed consent prior to her inclusion in the study. Details that might disclose the identity of the subjects under study were omitted.

Data availability statement

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

Additional information

Funding

This work is supported by the Youth Fund of Shandong Natural Science Foundation (No. ZR2022QH293) to Ziying Yuan from Science and Technology Department of Shandong Province.